


Precepts of Medical Ethics

by amorremanet



Series: the Mind Meld 'verse [6]
Category: Star Trek: The Original Series, Supernatural
Genre: Angst, Community: hc_bingo, Emotional Constipation, Friendship, Gen, M/M, Major Illness, Medical Procedures, Mental Health Issues
Language: English
Status: Completed
Published: 2013-06-27
Updated: 2013-06-27
Packaged: 2017-12-16 07:46:47
Rating: General Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 4,150
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/859657
Author URL: https://archiveofourown.org/users/amorremanet/pseuds/amorremanet
Summary: <blockquote class="userstuff">
              <p>
  <i> "You misunderstand me, Cas'tell," Spock says, voice still so calm that Cas can't even begin to fathom how he's managing to keep such an even temper. "I meant to ask, 'what do you think you're doing, attempting to treat Lieutenant Winchester, considering the nature of your relationship with him.'"</i>
</p>
            </blockquote>





	Precepts of Medical Ethics

**Author's Note:**

> Written for the prompt, "major illness" at hc_bingo.

Cas is still working on his paper in sickbay when the alarms start going off. He flinches, drops his PADD's stylus to the table, because they're always too loud for his sensitive ears, and when he recovers, he notices what the alarms were for: four members of the away team beamed directly into sickbay, but only three of them are on their feet. Only three of them are upright and still looking healthy.

One of them, a red-shirted Ensign who Cas doesn't recognize, rushes right past Cas's desk, in the direction of Doctor McCoy's office, and Cas blinks at him as he goes. Alert or not, why is he running so quickly? So Cas turns back to the transporter, wrinkles his nose at the rest of the away team.

And Dean's the one being carried, with Captain Kirk's hands under his arms and Commander Spock's around his knees. Reaching for his stylus, Cas freezes up—all he can manage is staring at the scene that unfolds before him. Spock and the Captain stretch Dean out on the nearest bed. Nurse Chapel's at their side immediately, waving a tricorder wand over Dean to check his vitals—blood pressure low and dropping fast, pulse and breathing rate plummeting, temperature unacceptably high. Doctor McCoy comes running out of his office and joins the scene, demands to know what in the Hell happened down there.

"No idea, Bones," Kirk tells him urgently. "We were surveying the surface of the planet, working on getting through one of the jungles, and out of nowhere, he just collapsed. Just like that—no warning, no anything."

"Did he eat or drink anything strange in the past two days?" Nurse Chapel says, grabbing up a PADD and, Cas presumes, jotting down Dean's vitals. "Did he collect any specimens that no one else touched?"

"To our knowledge, Lieutenant Winchester hasn't had any contact with any specimens we have collected," Spock says, standing fully upright with his hands behind his back, and Cas has no idea how he can stand at attention at a time like this. How he can keep perfectly calm as he goes on, "He has eaten nothing that the rest of us did not eat as well, and if you need to know more about his activities, then I suggest we beam up Lieutenant Uhura or Commander Scott as soon as possible. They were grouped together on the task of attempting to repair the village's replicators and parlaying with the local government representatives."

Cas tries to focus on the exchange of words—he tries to focus on the questions that Doctor McCoy and Nurse Chapel ask, and the answers that they get from Kirk, Spock, and the Ensign—but the whole world fades out as he looks at Dean. Dean, who's pale and sweating through his red shirt. Who's barely breathing and heaving his chest every time he manages to draw breath. Who's groaning and whining every time someone touches him, every time Doctor McCoy's fingers press into his throat, his chest, his stomach. Dean, who coughs from the pit of his stomach and so violently that Cas's core aches with sympathetic pain. Dean, who could all too easily die right here and now, before making Chief Engineer, the way he wants.

It takes Cas a moment to recognize that Doctor McCoy is attempting to check for swollen glands, and in the back of his mind, only vaguely, Cas realizes that he should leave—he should probably get out of here before anyone notices his presence and tries to make him leave, harasses him about his so-called feelings obstructing his ability to do his job to the best of his ability and insists that he'd only be a danger to the process of trying to get Dean well again… 

But he's a doctor, this sickbay is his hospital, and they have a patient to attend to. Sighing, Cas leaves his desk. He maneuvers around Spock and the Captain, sneaks over to the counter where the antiseptic lotion's sitting, starts to rub it into his hands—and he gasps when he feels something heavy drop onto his shoulder. When he looks down and sees a hand, when he turns and sees that it's just Captain Kirk, his cheeks flush and he can't help thinking how perfectly foolish he must seem to everyone. No one else would let themselves succumb to shock as much as Cas just did. No one else would wrinkle their nose up at Captain Kirk so much, either, not even in response to the borderline condescending furrow of Kirk's brow.

"What do you think you're doing, Cas'tell?" Spock says, arching an eyebrow in a way that suggests that there is only one right answer to this question, and that Cas probably knows what that answer is.

"Preparing to take a blood sample, Commander," Cas tells him with a curt nod. "We'll need to determine whether Dean's ailment is being caused by a viral, bacterial, or parasitic infection, and we'll need to see if it's having any effects on his cells… We'll need a blood sample to run all the tests, it's only logical."

Without another word, he reaches for the box of needles, only for Captain Kirk to grab his hand.

"You misunderstand me, Cas'tell," Spock says, voice still so calm that Cas can't even begin to fathom how he's managing to keep such an even temper. "I meant to ask, 'what do you think you're doing, attempting to treat Lieutenant Winchester, considering the nature of your relationship with him.'"

"I'm a doctor. I work here. I am perfectly capable of divorcing myself from my relationship with Dean in order to treat him—"

"You know we can't let you do that, son." Doctor McCoy at least has the decency to keep his voice solemn and to look at Cas like he's basically an equal, rather than looking at him as though he's some petulant child who's ruining everything for everyone. "Remember those precepts of medical ethics that you're sworn to uphold? Remember the rules about operating on and treating your loved ones?"

"Of course I remember them," Cas says before he's even thought about what his Chief Medical Officer means to imply here. Before he's thought about what, exactly, Doctor McCoy is attempting to say. As it all sinks in, Cas furrows his brow. "Dean isn't my family, Doctor—I don't even have a family—and with all due respect, this looks quite serious. You'll need an extra set of hands to help you find a cure."

"Nurse Chapel's hands are perfectly skilled and not currently in a relationship with the patient, Cas."

"Besides," Kirk adds, "he may not _legally_ be your family—but are you really going to stand here and deny that you and Dean share a—what'd you call it? A profound bond?"  

"Of course not, Captain," Cas sighs, looking down at Dean's sweat-soaked face. He swallows thickly, and he wants so very much to trace his fingers down Dean's cheek—but that wouldn't help him prove that he can still work on this patient. "Dean and I _do_ share a profound bond. That is why I want to help find a cure for whatever he contracted down on the planet's surface. That is why—"

"That is why you're going to get out of sickbay and go do something else with yourself," McCoy tells him sternly, reaching over Dean's bed to pat Cas's unoccupied shoulder. "Read a book, go talk to one of your friends, eat something—I don't care what you do as long as it's not related to this, and as long as you do it somewhere else. That's doctor's orders, by the way."

Cas huffs, and silently racks his brain for any possible excuse that he can find to stay. All of them crumble in the face of logic, though—and what's worse is that he's keeping Dean from getting treated. So he nods, and he excuses himself, and he grabs his PADD on the way out. He doesn't really have the heart to tell his boss that at least one of the options for things to do doesn't really apply to him. Cas might be healthy, and he might have a good job and a good relationship, he might be well on his way to becoming CMO someday—but he doesn't have very many friends.

Even if he did have friends, he wouldn't know what to say to them right now. He wouldn't make himself very good company, either. Logic dictates that Cas needs to handle this situation the same way that he handles everything else: by himself. Alone. Logically, and removed from all emotions.

*******

The first thing that Cas tries to do is simple: he tries to relax in Dean's quarters. He changes out of his scrubs. He sits at the computer and downloads enough papers to his PADD that his eyes glaze over and he loses track of exactly what the topics are, of exactly what he's supposed to be reading here. Cas has no idea why focusing makes his head hurt so much right now—Cas gets a dull throb behind his eyes as he tries to plow through a paper on the genetic causes of isoboromine deficiencies in unjoined Trills, and it makes no sense at all. Nothing about it makes any sense.

Dean's quarters are quiet, and sufficiently warm, and there's no reason why Cas should encounter any difficulties, especially not when he's so comfortable here, at this desk, with no one else around to distract him. At least, it makes no sense logically, and that's the only potential means of understanding the situation that Cas is willing to consider, at the moment. It's the only avenue of understanding the situation that he needs. If logic can't explain something about these circumstances, then that just means that Cas needs to find another task with which to occupy himself. Anything else will work.

So, reading in Dean's quarters doesn't work out very well, and Cas takes to wandering the corridors without any particular direction or any idea what he should be doing with himself. He goes down to engineering, but as Lieutenant Leslie points out after the fifth time he catches Cas peering into the engine room without coming in, there really isn't any point to Cas being down there. No one's so much as sniffling, so they don't need any medical attention, and since Dean isn't around for Cas to bother, all he's really doing is distracting everyone and getting in the way of their ability to keep the ship running smoothly.

Wandering itself isn't entirely ruled out, though, and Cas keeps ambling through the halls in search of… he has no idea what. He walks past Lieutenant Bradbury's quarters and ponders going in to talk to her. At the very least, she would share his concerns about Dean and his wellbeing—but on the other hand, she is very much _Dean's_ friend and not Cas's. She probably doesn't even like Cas very much, or anyway Cas wouldn't entirely blame her if she didn't. She shouldn't have insisted on discussing Klingons, and she shouldn't have run off her mouth about things that she doesn't understand, like Cas's lack of emotions. But still, he wasn't particularly kind to her, and when Dean wants so much for the two of them to be friends…

As he stumbles into the galley, Cas can't quite peg why everything seems so wrong, why he feels so wrong for the pointless nonsense with Lieutenant Bradbury. Logically, nothing's wrong at all—well, Dean is quite possibly dying of some unknown ailment, but at the same time, he's in Doctor McCoy's hands, and Doctor McCoy has Nurse Chapel's hands assisting him. Both of them are competent, both of them are capable. Neither of them will let anything happen to Dean—and Cas knows this. He can get a cup of coffee from the replicator and sit down with his PADD and start poring over his new articles. He's free to read up on myriad infections from planets he's never visited and different innovative treatments for them, or the ailments that are specific to certain species.

In fact, it's better for Cas to read up on these things than not, because it fulfills Doctor McCoy's request that he refrain from doing anything related to Dean's illness or trying to help cure it. There's most likely nothing of any use to Dean in articles about the Betazoid Zanthi Fever and the side-effects of viral infections on Trill symbionts. There's nothing immediately useful about these articles or their subject matter. There's nothing that's even of particular interest to Cas's paper—at most, there's one author's assertions about species-specific afflictions, and Cas isn't sure if his write-up about Commander Spock and Ambassador Sarek's operation needs to argue against them or not. Everything's too foggy and he has no idea why.

Either way, it's for the better that Cas never fully lets his work absorb him. When Meg sits down with him, she smacks the table, and Cas supposes, based on her disappointed pout, that he's meant to jump, or startle, or do _something_ more than sigh as he looks up at her. For a long moment, they don't say anything, just stare at each other, and for her part, Meg gets an expression like she's daring Cas to make the first move, to open his mouth first and start the conversation—or maybe she just has no idea what to say, either.

"Can I help you, Meg?" Cas says and clicks his PADD off, sets his stylus down.

"Actually," she huffs and smirks at him, "I'm here to help you. That is, if you're going to open up and let me help. Which I'm not exactly betting on, but you never know. You've surprised me before."

Cas rolls his eyes and slouches forward onto the table, propping himself up on his elbows. "I don't need any help, but thank you for the offer. What I _need_ is for my mind to clear itself so that I can focus on my reading. This research could end up being of great import to my paper."

Not that Cas can really complain about his mind being cluttered—he hasn't so much as tried to go through any of his meditation exercises. Not that he really can, not without going back to his quarters or to Dean's. As Commander Spock has told him several times, these exercises are meant to be private, and the galley is hardly that. Granted, it's not as crowded as it could be, but there are enough people here that it's public—Uhura and Sulu are quietly talking over dinner, Lieutenant Stiles is eating by himself, and a pair of blue-shirted Ensigns are drinking coffee and silently losing themselves in their own PADDs. No one's paying attention to Cas, but still, there are other people around who could watch him trying to meditate.

Never mind the way that Meg's watching him now, arching her eyebrow at him like a cat playing with a piece of string. "Yeah," she says, "I'm sure that your paper is the only thing that matters to you right now. I'm sure the Captain would specifically ask me to talk to you because of your paper."

"He might do so. I doubt he knows about my paper, but considering how he was involved in the events I'm writing up, he might be concerned with whether or not he's involved in the paper's account of them," Cas deadpans and tries not to think about Captain Kirk's head exploding or the different ways that he could make that happen—not least because, as Commander Spock says, Vulcans do not condone violence. Cas is fairly certain that using his knowledge of medicine to blow up his Captain's head would have to constitute violence. Not to mention mutiny and several other regrettable things that Cas has no desire to deal with.

"Well, Clarence, whatever you think about what Captain Kirk could want out of your paper? He really came to see me because he's concerned about _you_." Meg purses her lips and narrows her eyes at Cas, which gives him the sensation of being watched under a microscope or a magnifying glass. Never mind the way she taps her stylus on her own PADD. "He said that you got yourself kicked out of sickbay for trying to treat your boyfriend and being an obstinate little shit about being told that you couldn't help him."

"That's a somewhat melodramatic version of the events," Cas huffs. He probably shouldn't roll his eyes at his Commanding Officer's antics—it would probably be a massive show of disrespect, and since Meg is taking notes, it would get written down on some kind of record—but Cas still doesn't stop himself. He just picks up his own stylus again and twists it around his fingers for the sake of having something to do with his hands. "I was hardly _obstinate_ about attempting to help Doctor McCoy treat Dean. I merely pointed out that he could use an extra set of capable hands—my hands—around sickbay at the moment, which was an entirely logical statement, and motivated by nothing more than a desire to help our patients."

"And it had absolutely nothing to do with how the patient of the day is Dean, or with how you're sleeping with him or how you two are profoundly boning or whatever it is you like to say about your relationship with him?" 

"Profoundly _bonded_." Cas rolls his eyes again, but this time, it's only because Meg's sexual innuendo is juvenile and incredibly tiresome. Hardly befitting of a counselor, but then again, Meg doesn't seem inclined to do anything in the way that most people would have her do things. "That being said: yes, I attempted to stay in sickbay, and yes, it had nothing to do with my relationship with Dean. I care about Dean, but I tried to stay only because I thought that it would behoove me to do my job. Perhaps you should try following my example and doing _your_ job."  

"Oh, sweetheart, I _am_ doing my job," Meg drawls, smirking like the edge of a knife. "Captain Kirk came to my office and very specifically asked me to come talk to you, so that's what I'm doing. Besides, I don't have any appointments scheduled until tomorrow, so… I'm perfectly free to spend all the time I need to grilling you. Not that I particularly _want_ to grill you, or go prying into your thoughts, or do anything unethical. I'd much rather we had a nice, mutually cooperative little chat. But the point is that I could grill you, if I wanted to do that. I'm curious about how you're handling your boyfriend being sick."  

"I'm curious about why you went into psychology. Is it because you couldn't cut it in _real_ medicine?" With a small shrug, Cas gives Meg a Look that he hopes impresses on her the fact that, if she wants to grill him, she will need to deal with him putting up a considerable struggle.

Her smirk doesn't falter, and all she does is set her stylus down, fold her hands up on the table. "Actually, I got into it because I used to love making people cry on the playground. Now, I get to make them cry professionally and call it major emotional progress and maybe I'll get to write up a case study about it, if I can find somebody who's interesting enough and gives consent."

"Do I interest you?" Cas asks before he can think to stop himself—he doesn't even know why he cares that he might not be an interesting specimen for Meg to examine. It makes no logical sense at all. 

"As a friend, yes, you interest me a great deal," she says and picks up her stylus again, jots something down on her PADD. "As someone I want to write a paper about… yes. You still interest me in that regard as well. There isn't nearly enough literature on the psychological experiences of mixed-species humanoids."

That statement gives Cas pause, and for a moment, blinking at her is all he can do. He wants to ask her when they started being friends, exactly—after all, she's only been aboard the _Enterprise_ for a few months, and they haven't spent _that_ much time together. Not as far as Cas is concerned, anyway. He likes Meg, of course he does, and he has as much respect for her as he can manage for any counselor. Possibly more, just on the grounds that he likes her better than the other Betazoids he's met. But no one has called Cas their friend in some time. He's fairly certain that the last time it happened was in elementary school, and that friendship didn't last that long.  

"How fortunate for you that we found each other, then," is all he ends up saying. Cas supposes that he can't fault Meg for wanting to write a paper about him. He can't say that he really likes the idea of being the subject of her next case study, either, but it is perfectly logical to see a gap in the research and want to fill it.

"Well, it's really only fortunate for me if you give me consent to write a paper about you. Which you are under no obligation to do at any point," she points out, and shrugs. "But in the meantime, I have to report back to Kirk about how you're doing, so… what am I going to tell our Captain about that, hmm?"

"I wouldn't purport to know what you're going to tell him." It takes Cas a moment of watching Meg, watching the way exasperated that she looks at him, for Cas to realize what Meg is actually asking him. "…Oh. Well. If I were you, I would tell Captain Kirk that I'm doing perfectly fine. After all, I'm healthy, I have a good job and a good relationship, and I'm progressing toward my goal of becoming someday Chief Medical Officer. Logically, everything is quite well."

"Paradoxically, that doesn't really sound like a ringing endorsement for you being fine." Tapping her stylus on the table in an ear-grating, perfectly measured rhythm, Meg sighs. "Oh, sure, I believe that you could be doing a lot worse, but going on about how you're perfectly fine while your boyfriend's dying of this week's mysterious alien illness? Not actually that reassuring on the, 'Cas'tell is completely fine' front."

Cas has to fight off a powerful impulse to groan, and he only barely manages to do so. "Of course I am concerned about Dean, Meg, but it seems illogical to succumb to worry or any other emotions that I don't feel when I can do nothing about anything. I've been temporarily banned from entering sickbay, I'm not even supposed to be thinking about Dean right now, or about treating him, or about anything that might pertain to treating him—"

"But you _are_ thinking about it, aren't you?" Meg says, and her smirk softens into something sympathetic-looking. Well, almost—there's still an edge in the way she furrows her brow. "You're thinking about how you could be helping Doctor McCoy, if only he'd let you back into sickbay? About how you would do anything to get Dean better, so why don't they trust you to help?"

"Possibly. …More than possibly. Which I suppose you'd know if you're using your abilities to their full extent—and I sincerely hope that you aren't." Cas sighs and runs his hand back through his hair. "I mean that: please don't telepathically spy on me. I'll be perfectly honest with you as long as you don't pry into my thoughts."

He waits for her to nod and bid him to go on, then huffs. "There's nothing that I wouldn't do to help Dean—and that is exactly why I can't be in sickbay right now. My judgment is clouded, no matter how much I might insist otherwise. My thoughts are a mess, my stomach won't settle down, there's no cause for any of this—I can't even be in my quarters or Dean's and it makes _no_ sense. So maybe I am not as fine as I would like you to believe."

"Maybe you're not, no," she says, and reaches over to squeeze his gloved hand. "But admitting that you're not fine is the first step to actually being fine, okay?"

As he slips his hand out from under hers, as he takes a long drink of coffee, Cas very much wishes that he could believe Meg—but the fact of the matter remains: maybe logic isn't helping him as much as it should. Maybe everything isn't quite as simple as that.


End file.
